Eating Disorders Food

EATING DISORDERS

Types of Eating Disorders and their Treatments

Abstract

Food is essential to live, grow and survive. Healthy living depends on a balanced diet through healthy food supplements. Neither compulsive nor less eating serve the purpose of a healthy life. Therefore, it results in various eating disorders. Research indicates that girls are more prone to eating disorders than boys. There are three main types of eating disorders: Anorexia Nervosa, Bulimia Nervosa and Binge Eating. The fourth type of eating disorder is Eating Disorder Not Otherwise Specified (EDNOS). Those cases of eating disorders that do not fulfill the diagnostic criteria of either the three main types are classified as EDNOS. Various therapies and medications are used for the treatment of eating disorders depending on its cause and type.

Types of Eating Disorders and their Treatments

Eating Disorder is an obsessive attitude to food; it is an emotional disorder that manifests itself in an irrational craving for, or avoidance of food. Eating Disorders is an extreme expression of food and weight issues. Eating Disorder is a phenomenon that is free of age or sex, yet some studies suggest that women or girls and teens are more prone to this disorder. Eating disorder is actually not about food, but about self worth, perception and esteem. Eating disorders are serious mental illnesses in which emotions and thinking patterns cause a person to adopt harmful eating habits, such as overeating or starving.

Eating Disorder does not occur from a single cause; rather it is a combination of many factors which may include events, feelings or pressures. The events can be many, ranging from family problems to social problems, problems concerning office work or change of job, issues regarding marriage, higher education and alike. Yet these problems are pole apart, they cast shadows and doubts on a person mind and these imbalances in life leads to imbalances in overall person's life. Many people knowingly avoid food to stay and look good; some do it for the sake of their work like looking skinny in a fashion industry.

There are three main types of eating disorders: Anorexia Nervosa, Bulimia Nervosa and Binge Eating. Apart from these three main types of eating disorders there is another disorder which is known as Eating Disorder Not Otherwise Specified (EDNOS).

Anorexia Nervosa

The first type of eating disorder is Anorexia Nervosa which is commonly referred to as “Anorexia”. Anorexia is a state that goes beyond dieting. A person with anorexia initially begins dieting to lose weight. With the passage of time, weight loss becomes a sign of control. The urge to become thinner and to lose weight is actually derived from the concerns about control or fears relating to one's body. The individual continues the never-ending cycle of compulsive dieting or restrictive eating often to a point close to starvation which may lead to death. As a result, continued and excessive dieting takes the form of drug addiction. People who eat too little as a result of a disease do not fall under the category of anorexia. Anorexics often deny that they are underweight, or ill, just as alcoholics deny that they are addicted to alcohol. “The National Institute of Mental Health (NIMH) estimates that one in ten anorexia cases end in death from starvation, suicide or medical complications like heart attacks or kidney failure” (Psychotherapy's Role in Effective Treatment, 2007).

Dieting is different from Anorexia (Helpguide, 2008) .The three main differences are mentioned below:

• Losing weight is considered as a method to improve health and appearance in Dieting, whereas in Anorexia it is considered as a method to achieve happiness.

• Healthy Dieting is an attempt to control weight, whereas Anorexia is an attempt to control life and emotions.

• Self-esteem in Healthy Dieting goes beyond than just weight and body image, whereas Anorexia is based solely on weight and body image.

Various therapies are used to treat people with anorexia. Individual therapy, cognitive-behavioral therapy (CBT), group therapy, and family therapy have all been successful in treating anorexia (Martin, Volkmar, Lewis, 2007. p. 621).

The treatment from therapies goes beyond than just changing the individual's eating habits. Anorexic patients often need counseling for a year or more so they can change their feelings and eating habits which causes Anorexia. These feelings are about their family problems and their self-esteem. Patients suffering from Anorexia are also treated with various antidepressants which are prescribed by a doctor and are used along with counseling.

Bulimia Nervosa

The second type of eating disorder is Bulimia Nervosa which is commonly referred to as “Bulimia”. “People with bulimia consume large amounts of food and then get rid of the excess calories by purging (such as self-induce vomiting, misuse of laxatives, diuretics or enemas) or by non-purging (such as excessive exercise or fasting) behaviors” (David, Society And Eating Disorders, 2008).

This state of overeating and purging quickly transforms into an addictive behavior. As a result, the individual feels loss of control during overeating and the purging/non-purging behavior becomes a way of regaining control. Bulimics usually have menstrual irregularities and a reduced sex drive. “According to The National Institute of Mental Health (NIMH) 1.1% to 4.2% of females have bulimia at some point in their lives” (Bulimia: Overcoming, Counseling, and Treatment, 2008).

Bulimia is extremely harmful. Each type of purging and non-purging behaviors has varied effects on the human body. The misuse of laxatives and diuretics results in loss of sodium and potassium that damages the heart muscle, increasing the risk for irregular heart beats leading to heart attack and even death. Also, misuse of laxatives results in constant dehydration and constipation. Self-induced vomiting damages teeth, increase dental cavities, and makes teeth very sensitive to hot and cold food. Soreness and swelling in the salivary glands can also occur. Also, repeat vomiting can result in irritation in throat, esophagus, and stomach. It can also lead to pneumonia due to increase in the likelihood of lung aspiration of the vomit. Vomiting also causes the gums to ebb and erodes tooth enamel. Excessive exercise causes permanent damage to ligaments, bones, tendons, cartilage, and joints. Instead of building the muscle, too much exercise actually destroys muscle, especially if the body is not getting enough nutrition, forcing it to break down muscle for energy. “Most complications of bulimia result from electrolyte (salt in the blood) imbalance or trauma from repeated purging behaviors” (Complications of Bulimia nervosa, 2008)

For the treatment of Bulimia both physical and psychological needs of the patient are addressed. In most cases, treatment is conducted by a team of medical, nutritional, and mental health care professionals who evaluate the symptoms of the disorder and provide medications. The most successful treatment is a combination of counseling, behavioral therapy, education, and regular antidepressant medications such as Prozac, Zoloft, Paxil, or Luvox. Goal of the treatment is to change the individual's attitude about eating, weight, and body image (Boyd, 2004, p.339).

People suffering from bulimia require ongoing medical attention related to stomach and esophagus injuries, as well as colon and kidney damage. Bulimics often need extensive dental care as well.

Binge Eating

The third type of eating disorder is Binge Eating which is also referred to as “compulsive overeating”. This type of disorder is characterized by uncontrollable eating and a resulting weight gain. People with binge eating disorder frequently consume large amount of food. So it is similar to bulimia nervosa, but people with binge eating disorder do not engage in purging behaviors by self-induce vomiting, misuse of laxatives or diuretics. Research indicates that causes of binge eating disorder are still unknown (Binge Eating Disorder, 2007).

Most individuals suffering from binge eating have a history of depression, anger, sadness, boredom, anxiety or other negative emotions. The major complications of binge eating disorder include diabetes, high blood pressure, high cholesterol levels, gallbladder disease, heart disease, and cancer (Eating Disorders, 2008).

Patients of binge eating should seek advice of a medical expert and opt for a proper treatment rather than dieting because dieting could worsen binge eating. Apart from antidepressants, various therapies are used for treating binge eating disorders such as cognitive-behavioral therapy, Interpersonal psychotherapy and group therapy (Binge Eating Disorder, 2008).

Cognitive-behavioral therapy (CBT)

This therapy is used to change the behavior and thinking patterns of the patients suffering from binge eating. It helps to restore normal eating patterns, and to teach the importance of nutrition and a balanced diet. It focuses on the techniques for developing healthy attitude towards weight and food. This therapy also focuses on the approaches to handle difficult situations.

Interpersonal Psychotherapy

Interpersonal therapy focuses on the relationships with friends and family and to make changes in problem areas. It is one of the short term therapies that proves to be effective for the treatment of depression and binge eating disorder. Interpersonal Psychotherapy is the treatment of mental and emotional health conditions, using talking and listening.

Group Therapy

Group therapy focuses on family support which is very important for the treatment success. People with eating disorders benefits from group therapy by finding support and discussing their feelings and concerns with others who share common experiences and problems.

Eating Disorder Not Otherwise Specified (EDNOS)

This is the fourth type of eating disorder. It is the category to which eating disorders are assigned if they fail to fulfill diagnostic criteria for Anorexia, Bulimia and Binge Eating (American Psychiatric Association, 2006, p.1149).

There are certain guidelines which are considered in diagnosing EDNOS. “Diagnostic and Statistical Manual of Mental Disorders” (DSM-IV) of the American Psychiatric Association, and the “International Classification of Disease” (ICD-10) by the World Health Organization provides the complete diagnostic criteria for eating disorders. Some guidelines for diagnosing EDNOS are discussed below:

• EDNOS is diagnosed when the weight of a person is 87% of Ideal Body Weight (IBW), because the diagnostic criteria suggest that in order to be anorexic the individual should weigh no more than 85% of IBW.

• EDNOS is diagnosed when binging and purging behaviors occurs once in a week, because the diagnostic criteria suggest that in order to be bulimic the individual should binge and purge at least twice in a week.

• EDNOS is diagnosed when the individual have the symptoms of both anorexia and bulimia, but does not meet the entire medical criteria for either disorder.

Like other eating disorders, EDNOS is also very harmful to the body. Osteoporosis, heart failure, kidney problems, retard growth and ulcers and are the major problems faced by the patients of EDNOS, and if these problems are left unattended can lead to death. There are four types of EDNOS. Prader-Willi Syndrome, Bigorexia, Night Eating Syndrome and Pica. (Other Types of Eating Disorders, 2008)

Prader-Willi Syndrome (PWS)

This type of EDNOS begins in childhood where one develops constant overeating and avid appetite. As a result, individuals experience rapid weight gain which leads to obesity. Poor growth, feeding difficulties and hypotonia (muscle weakness) are the characteristics of PWS in infants. Distinctive facial features such as narrow face, almond-shaped eyes, small-appearing mouth and thin upper lip are also identified in children suffering from PWS. So far, no cure has been found for PWS. However, the physical problems caused by PWS can be managed. Infant's growth can be managed during infancy by special feeding techniques and formulas. Physical exercise and Speech therapy is also helpful in improving strength and coordination of the individual suffering from PWS. Daily exercise, weight monitoring and balanced low-calorie diet overcomes the problems related to eating and weight.

Bigorexia

This type of EDNOS begins when a person feels that he is too thin and goes to great lengths to increase the body mass by building muscles. Bigorexia is commonly found in body builders (Taylor, Wilson, p.211). Bigorexia may seem harmless, but the methods which are used to increase the body mass such as steroids and hormone are dangerously high in protein which can cause serious damage to the kidneys, even kidney failure. Various cognitive-behavioral, educational and psychotherapeutic therapies have proven successful for the treatment of Bigorexia.

Night Eating Syndrome

This type of EDNOS is classified by decreased breakfast appetite. It is triggered by depression, boredom, prolonged dieting and interpersonal stressors. People consume more than fifty percent of daily calories after the evening meal. They wake up at least once in a night to consume high-carbohydrate snacks which causes insomnia. Food eaten during the night time is often high caloric because it is not properly digested. As a result, the person is usually not hungry in the morning. Nutritional and medical counseling are used for the treatment purposes (MamasHealth, 2008).

Pica

Pica is a Latin word meaning magpie, a bird known for its unusual habits for eating just about anything. This type of EDNOS is classified by the practice of eating non-nutritive substances such as coal, dirt, chalk, paper etc. The eating pattern should last for at least one month to fit the diagnosis of pica. “Diagnostic and Statistical Manual of Mental Disorders” (DSM -IV) describes it as feeding and eating disorder of childhood. “Pica is not diagnosed before age two, because it is common and normal for babies to try to eat non-food objects or to chew non-food objects when they are teething.” Pica can also occur during pregnancy. Pica is due to the deficiencies of minerals such as iron and zinc. Pica causes phosphorus intoxication, intestinal blockages, abdominal problems, malnutrition, lead or mercury poisoning and dental problems. There are three types of pica. Geophagia is described as abnormal eating of soil or clay, Pagophagia is described as abnormal eating of ice and Amylophagia is described as abnormal eating of soil or clay. (Pica, 2006)

The treatment of pica involves addressing the problem of missing nutrients. There are various treatments of pica depending on its cause and type; these include behavior and development approach, environmental approach and family education approach. The most successful treatment is the Mild aversion therapy which uses punishment followed by positive reinforcement to change the eating habits (The New York, Times, 2008)

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